Abstract | BACKGROUND: METHODS AND RESULTS: One hundred and ninety-five clinical HCM patients were studied. QTc duration was derived applying Bazett's formula; fQRS was defined as presence of various RSR' patterns, R or S notching and/or >1 additional R wave in any non-aVR lead in patients without pacing or (in)complete bundle branch block. The endpoints comprised SCD, ECG documented sustained VTA ( tachycardia or fibrillation) or appropriate implantable cardioverter defibrillator (ICD) therapies (antitachycardia pacing [ ATP] or shock) for VTA in ICD recipients (n = 58 [30%]). QT prolonging drugs recipients were excluded. After a median follow-up of 5.7 years (IQR 2.7-9.1), 26 (13%) patients experienced VTA or SCD. Patients with fQRS in ≥3 territories (inferior, lateral, septal, and/or anterior) (p = 0.004) or QTc ≥460 ms (p = 0.009) had worse cumulative survival free of VTA/SCD than patients with fQRS in <3 territories or QTc <460 ms. fQRS in ≥3 territories (ß 4.5, p = 0.020, 95%CI 1.41-14.1) and QTc ≥460 ms (ß 2.7, p = 0.037, 95%CI 1.12-6.33) were independently associated with VTA/SCD. Likelihood ratio test indicated assessment of fQRS and QTc on top of conventional SCD risk factors provides incremental predictive value for VTA/SCD (p = 0.035). CONCLUSIONS: Both fQRS in ≥3 territories and QTc duration are associated with VTA/SCD in HCM patients, independently of and incremental to conventional SCD risk factors.
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Authors | Philippe Debonnaire, Spyridon Katsanos, Emer Joyce, Olivier V W VAN DEN Brink, Douwe E Atsma, Martin J Schalij, Jeroen J Bax, Victoria Delgado, Nina Ajmone Marsan |
Journal | Journal of cardiovascular electrophysiology
(J Cardiovasc Electrophysiol)
Vol. 26
Issue 5
Pg. 547-55
(May 2015)
ISSN: 1540-8167 [Electronic] United States |
PMID | 25648421
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2015 Wiley Periodicals, Inc. |
Topics |
- Action Potentials
- Adult
- Aged
- Cardiomyopathy, Hypertrophic
(complications, diagnosis, mortality, physiopathology, therapy)
- Death, Sudden, Cardiac
(etiology, prevention & control)
- Defibrillators, Implantable
- Disease-Free Survival
- Electric Countershock
(instrumentation)
- Electrocardiography
- Female
- Heart Conduction System
(physiopathology)
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Predictive Value of Tests
- Proportional Hazards Models
- Registries
- Risk Factors
- Tachycardia, Ventricular
(diagnosis, etiology, mortality, physiopathology, therapy)
- Time Factors
- Treatment Outcome
- Ventricular Fibrillation
(diagnosis, etiology, mortality, physiopathology, therapy)
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